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Organization
DESERT LILY DENTAL
Active
Organization
DESERT LILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY BRAY (MANAGER)
(435) 637-2100
Entity
Organization
Contact information
Practice address
12020 N 35TH AVE STE 2, PHOENIX, AZ 85029-3213
(435) 637-2100
Mailing address
12020 N 35TH AVE STE 2, PHOENIX, AZ 85029-3213
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
NULL
Other
Enumeration date
02/15/2021
Last updated
02/15/2021
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